BNT162b2 and mRNA-1273 Vaccine Effectiveness against SARS-CoV-2 and Variants in the Urban Underserved Population
Researchers evaluated the mRNA vaccine effectiveness in preventing SARS-CoV-2 infections at a major federally qualified health center in Providence, Rhode Island, and a total of 38,602 patients were included. Time period was used as the SARS-CoV-2 variant proxy. Compared to the unvaccinated group, the adjusted vac- cine effectiveness for 2 doses of BNT162b2 and mRNA- 1273 were 94.6% and 97.5% respectively against the alpha variant/wild type, which dropped to 64.8% and 65.0% respectively against the delta variant and 31.6% and 25.6% respectively against the omicron variant.
Full Access: RIMED
Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment
In this evaluation of 188 551 patients attended by ambulance for chest pain in Victoria, Australia, the estimated annual statewide cost savings of prehospital risk stratification and troponin measurement was $6.45 million without using prehospital discharge and $42.84 to $71.84 million if prehospital discharge was used for low-risk patients. The findings suggest that prehospital risk assessment and point-of-care troponin testing may be viable based on cost savings alone, and investment should be considered by health services provided that safety is confirmed in prospective studies.
Full Access: JAMA
Even One Head Injury Boosts All-Cause Mortality Risk
An analysis of more than 13,000 adult participants in the Atherosclerosis Risk in Communities (ARIC) study showed a dose-response pattern in which one head injury was linked to a 66% increased risk for all-cause mortality, and two or more head injuries were associated with twice the risk in comparison with no head injuries.
Full Access: Medscape
Managing Mild Hypertension During Pregnancy
In the Chronic Hypertension and Pregnancy (CHAP) trial, 2400 pregnant women with mild hypertension (at <23 weeks’ gestation) were randomized either to receive antihypertensive medication if BP exceeded 140/90 mm Hg or to be managed expectantly unless BP exceeded 160/105 mm Hg. Compared with expectant management, drug treatment (targeting a BP <140/90 mm Hg) significantly lowered the incidence of the primary endpoint (30% vs. 37%), with most of this difference attributed to lower risks for preeclampsia and preterm delivery. Fetal growth restriction was not associated with lowering blood pressure below 140/90 mm Hg.
Full Access: NEJM
